The first symptoms of Tourette syndrome usually occur during childhood with an average onset of between 3 and 9 years old. The main symptom is tics—repetitive, involuntary movements or vocalizations. Tics are classified as simple (movements involving a limited number of muscle groups) or complex (patterns of movement involving multiple muscle groups).
Common simple motor tics include head jerking, shoulder shrugging, eye blinking, and facial grimacing. Complex motor tics are a combination of these types of movements. Simple vocal tics include repetitive throat-clearing, grunting, or sniffing, while complex vocal tics involve words or phrases. The most disabling tics involve self-harm such as punching oneself, calling out inappropriate words or swearing, and repeating others’ words. Tics can vary in frequency and severity, and may be heightened with excitement, anxiety, and certain physical or environmental triggers.
Many people with Tourette syndrome also have neurobehavioral problems like hyperactivity, inattention, impulsivity, and obsessive-compulsive thoughts and behavior.
Tourette syndrome can be a chronic disease. However, symptoms are typically the worst during the early teenage years and show improvement in the late teens and adulthood. For some with Tourette syndrome, symptoms will mostly go away in adulthood and no longer require treatment. But for approximately 10%-15% of people with Tourette syndrome, the disease lasts into adulthood.